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Wolfe CM, Barry A, Campos A, Farham B, Achu D, Juma E, Kalu A, Impouma B. Control, elimination, and eradication efforts for neglected tropical diseases in the World Health Organization African region over the last 30 years: A scoping review. Int J Infect Dis 2024; 141:106943. [PMID: 38266976 PMCID: PMC10927616 DOI: 10.1016/j.ijid.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/08/2024] [Accepted: 01/16/2024] [Indexed: 01/26/2024] Open
Abstract
OBJECTIVES NTDs historically receive less attention than other diseases in the same regions. Recent gap analyses revealed notable shortcomings despite NTD elimination progress. This systematic scoping review was conducted to understand NTD control, elimination, and eradication efforts in the WHO African region over the last 30 years. METHODS Peer-reviewed publications from PubMed, Web of Science, and Cochrane databases related to NTD control, elimination, and eradication in the WHO African Region from 1990 to 2022 were reviewed. Included articles were categorized based on NTD; study location, type, and period; and topic areas. Technical and guidance documents from WHO, UN, partner, and academic/research institutions were reviewed. Country-specific multi-year NTD master plans were documented. RESULTS Four hundred eighty peer-reviewed articles, six Cochrane reviews, and 134 technical reports were included. MDA and non-interventional/survey-related studies were common topics. Lymphatic filariasis, trachoma, schistosomiasis, and onchocerciasis were the most frequently studied NTDs. Tanzania, Ethiopia, and Nigeria were the most represented countries; multi-country studies were limited. CONCLUSION The review highlights progress made in NTD control, elimination, and eradication efforts in the WHO African Region and can inform national/regional strategies. Disease and geographical disparities were evident, warranting focus and research in certain countries. A standardized approach to NTD control programs is needed for sustained progress. FUNDING There was no funding source for this study.
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Affiliation(s)
- Caitlin M Wolfe
- World Health Organization Regional Office for Africa, B.P. 06 Cité de Djoué, Brazzaville, Congo; University of South Florida College of Public Health, 13201 Bruce B Downs Boulevard, Tampa, FL 33612, USA.
| | - Abbie Barry
- World Health Organization Regional Office for Africa, B.P. 06 Cité de Djoué, Brazzaville, Congo
| | - Adriana Campos
- World Health Organization Regional Office for Africa, B.P. 06 Cité de Djoué, Brazzaville, Congo; University of South Florida College of Public Health, 13201 Bruce B Downs Boulevard, Tampa, FL 33612, USA
| | - Bridget Farham
- World Health Organization Regional Office for Africa, B.P. 06 Cité de Djoué, Brazzaville, Congo
| | - Dorothy Achu
- World Health Organization Regional Office for Africa, B.P. 06 Cité de Djoué, Brazzaville, Congo
| | - Elizabeth Juma
- World Health Organization Regional Office for Africa, B.P. 06 Cité de Djoué, Brazzaville, Congo
| | - Akpaka Kalu
- World Health Organization Regional Office for Africa, B.P. 06 Cité de Djoué, Brazzaville, Congo
| | - Benido Impouma
- World Health Organization Regional Office for Africa, B.P. 06 Cité de Djoué, Brazzaville, Congo
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Mboussou F, Nkamedjie P, Oyaole D, Farham B, Atagbaza A, Nsasiirwe S, Costache A, Brooks D, Wiysonge CS, Impouma B. Rapid assessment of data systems for COVID-19 vaccination in the WHO African Region. Epidemiol Infect 2024; 152:e50. [PMID: 38497495 PMCID: PMC11022257 DOI: 10.1017/s0950268824000451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/16/2023] [Accepted: 03/07/2024] [Indexed: 03/19/2024] Open
Abstract
Most countries in Africa deployed digital solutions to monitor progress in rolling out COVID-19 vaccines. A rapid assessment of existing data systems for COVID-19 vaccines in the African region was conducted between May and July 2022, in 23 countries. Data were collected through interviews with key informants, identified among senior staff within Ministries of Health, using a semi-structured electronic questionnaire. At vaccination sites, individual data were collected in paper-based registers in five countries (21.7%), in an electronic registry in two countries (8.7%), and in the remaining 16 countries (69.6%) using a combination of paper-based and electronic registries. Of the 18 countries using client-based digital registries, 11 (61%) deployed the District Health Information System 2 Tracker, and seven (39%), a locally developed platform. The mean percentage of individual data transcribed in the electronic registries was 61% ± 36% standard deviation. Unreliable Internet coverage (100% of countries), non-payment of data clerks' incentives (89%), and lack of electronic devices (89%) were the main reasons for the suboptimal functioning of digital systems quoted by key informants. It is critical for investments made and experience acquired in deploying electronic platforms for COVID-19 vaccines to be leveraged to strengthen routine immunization data management.
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Affiliation(s)
- Franck Mboussou
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | | | - Daniel Oyaole
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Bridget Farham
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Ajiri Atagbaza
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | - Sheillah Nsasiirwe
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
| | | | - Donald Brooks
- World Health Organization, Department of Immunization, Vaccines & Biologicals, Geneva, Switzerland
| | | | - Benido Impouma
- World Health Organization, Regional Office for Africa, Brazzaville, Congo
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Onwujekwe O, Mbachu C, Okeibunor J, Ezema GU, Ejiofor N, Braka F, Thiam A, Koua EL, Chamla D, Gueye AS. What are the research priorities for strengthening public health emergency preparedness and response in Africa? Health Res Policy Syst 2023; 21:107. [PMID: 37872548 PMCID: PMC10594758 DOI: 10.1186/s12961-023-01059-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 10/06/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Research evidence is needed to strengthen capacities in emergency preparedness and response (EPR). However, the absence of a clear research agenda limits the optimal use of research evidence. This paper reports on the prioritization of research questions and topics that could contribute to evidence-informed strengthening of EPR capacities in the African region. METHODS The priority-setting consisted of desk review and stakeholder consultation workshop. Twenty-nine people participated in the workshop, including representatives from WHO regional office and EPR focal points in Africa, representatives of research institutions, and partners from Science for Africa Foundation, United Nations Children's Fund and Africa Center for Disease Control. Modified Delphi technique was used to systematically arrive at specific and cross-cutting research priorities in the three broad areas of the EPR, which are program Implementation, Clinical and Epidemiology. The research questions/topics were ranked on five-point Likert scale (1 = very low to 5 = very high) based on seven agreed-on criteria. Research priority score was calculated for each question as the mean of the criteria scores. RESULTS A total of 123 research questions comprising, 29 on Epidemiology, 22 on Clinical, 23 on program Implementation, and 49 on cross-cutting issues were ranked. The top ten research priorities were: knowledge and skills of healthcare workers in detecting and responding effectively to disease outbreaks; quality of data (accuracy, timeliness, completeness) for epidemic prone diseases; determinants of vaccine hesitancy; determinants of infection transmission among health care workers during PHE; effective measures for protecting health workers from highly infectious pathogens in PHE; strategies to improve the effectiveness of contact tracing for epidemic prone diseases; effectiveness of current case definitions as screening tools for epidemic and pandemic prone diseases; measures to strengthen national and sub-national laboratory capacity for timely disease confirmation within the Integrated Diseases Surveillance and Response framework; factors affecting prompt data sharing on epidemic-prone diseases; and effective strategies for appropriate community participation in EPR. CONCLUSIONS The collaborative multi-stakeholder workshop produced a starting list of priority research questions and topics for strengthening EPR capacities in Africa. Action needs to be taken to continuously update the research agenda and support member States to contextualize the research priorities and commission research for timely generation and uptake of evidence.
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Affiliation(s)
- Obinna Onwujekwe
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu, 400001, Nigeria
- Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu, 400001, Nigeria
| | - Chinyere Mbachu
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu, 400001, Nigeria.
- Department of Community Medicine, College of Medicine, University of Nigeria, Enugu, 400001, Nigeria.
| | - Joseph Okeibunor
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
| | - Godwin Uchenna Ezema
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu, 400001, Nigeria
- Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu, 400001, Nigeria
- Enugu State Primary Healthcare Development Agency, Enugu, Nigeria
| | - Nonso Ejiofor
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
| | - Fiona Braka
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
| | - Adama Thiam
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
| | - Etien Luc Koua
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
| | - Dick Chamla
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
| | - Abdou Salam Gueye
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
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Mboussou F, Farham B, Nsasiirwe S, Atagbaza A, Oyaole D, Atuhebwe PL, Alegana V, Osei-sarpong F, Bwaka A, Paluku G, Petu A, Efe-Aluta O, Kalu A, Bagayoko MM, Impouma B. COVID-19 Vaccination in the WHO African Region: Progress Made in 2022 and Factors Associated. Vaccines (Basel) 2023; 11:1010. [PMID: 37243114 PMCID: PMC10223522 DOI: 10.3390/vaccines11051010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/13/2023] [Accepted: 03/17/2023] [Indexed: 05/28/2023] Open
Abstract
This study summarizes progress made in rolling out COVID-19 vaccinations in the African region in 2022, and analyzes factors associated with vaccination coverage. Data on vaccine uptake reported to the World Health Organization (WHO) Regional Office for Africa by Member States between January 2021 and December 2022, as well as publicly available health and socio-economic data, were used. A negative binomial regression was performed to analyze factors associated with vaccination coverage in 2022. As of the end of 2022, 308.1 million people had completed the primary vaccination series, representing 26.4% of the region's population, compared to 6.3% at the end of 2021. The percentage of health workers with complete primary series was 40.9%. Having carried out at least one high volume mass vaccination campaign in 2022 was associated with high vaccination coverage (β = 0.91, p < 0.0001), while higher WHO funding spent per person vaccinated in 2022 was correlated with lower vaccination coverage (β = -0.26, p < 0.03). All countries should expand efforts to integrate COVID-19 vaccinations into routine immunization and primary health care, and increase investment in vaccine demand generation during the transition period that follows the acute phase of the pandemic.
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Affiliation(s)
- Franck Mboussou
- World Health Organization, Regional Office for Africa, Brazzaville P.O. Box 06, Congo
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Wei G, Sun P, Jiang S, Shen Y, Liu B, Zhang Z, Ouyang X. The Driving Influence of Multi-Dimensional Urbanization on PM 2.5 Concentrations in Africa: New Evidence from Multi-Source Remote Sensing Data, 2000-2018. Int J Environ Res Public Health 2021; 18:9389. [PMID: 34501979 DOI: 10.3390/ijerph18179389] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/31/2021] [Accepted: 09/03/2021] [Indexed: 12/22/2022]
Abstract
Africa’s PM2.5 pollution has become a security hazard, but the understanding of the varying effects of urbanization on driven mechanisms of PM2.5 concentrations under the rapid urbanization remains largely insufficient. Compared with the direct impact, the spillover effect of urbanization on PM2.5 concentrations in adjacent regions was underestimated. Urbanization is highly multi-dimensional phenomenon and previous studies have rarely distinguished the different driving influence and interactions of multi-dimensional urbanization on PM2.5 concentrations in Africa. This study combined grid and administrative units to explore the spatio-temporal change, spatial dependence patterns, and evolution trend of PM2.5 concentrations and multi-dimensional urbanization in Africa. The differential influence and interaction effects of multi-dimensional urbanization on PM2.5 concentrations under Africa’s rapid urbanization was further analyzed. The results show that the positive spatial dependence of PM2.5 concentrations gradually increased over the study period 2000–2018. The areas with PM2.5 concentrations exceeding 35 μg/m3 increased by 2.2%, and 36.78% of the African continent had an increasing trend in Theil–Sen index. Urbanization was found to be the main driving factor causing PM2.5 concentrations changes, and economic urbanization had a stronger influence on air quality than land urbanization or population urbanization. Compared with the direct effect, the spillover effect of urbanization on PM2.5 concentrations in two adjacent regions was stronger, particularly in terms of economic urbanization. The spatial distribution of PM2.5 concentrations resulted from the interaction of multi-dimensional urbanization. The interaction of urbanization of any two different dimensions exhibited a nonlinear enhancement effect on PM2.5 concentrations. Given the differential impact of multi-dimensional urbanization on PM2.5 concentrations inside and outside the region, this research provides support for the cross-regional joint control strategies of air pollution in Africa. The findings also indicate that PM2.5 pollution control should not only focus on urban economic development strategies but should be an optimized integration of multiple mitigation strategies, such as improving residents’ lifestyles, optimizing land spatial structure, and upgrading the industrial structure.
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Motari M, Nikiema JB, Kasilo OMJ, Kniazkov S, Loua A, Sougou A, Tumusiime P. The role of intellectual property rights on access to medicines in the WHO African region: 25 years after the TRIPS agreement. BMC Public Health 2021; 21:490. [PMID: 33706726 PMCID: PMC7951129 DOI: 10.1186/s12889-021-10374-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 02/02/2021] [Indexed: 11/12/2022] Open
Abstract
Background It is now 25 years since the adoption of the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and the same concerns raised during its negotiations such as high prices of medicines, market exclusivity and delayed market entry for generics remain relevant as highlighted recently by the Ebola and COVID-19 pandemics. The World Health Organization’s (WHO) mandate to work on the interface between intellectual property, innovation and access to medicine has been continually reinforced and extended to include providing support to countries on the implementation of TRIPS flexibilities in collaboration with stakeholders. This study analyses the role of intellectual property on access to medicines in the African Region. Methods We analyze patent data from the African Regional Intellectual Property Organization (ARIPO) and Organisation Africaine de la Propriété Intellectuelle (OAPI) to provide a situational analysis of patenting activity and trends. We also review legislation to assess how TRIPS flexibilities are implemented in countries. Results Patenting was low for African countries. Only South Africa and Cameroon appeared in the list of top ten originator countries for ARIPO and OAPI respectively. Main diseases covered by African patents were HIV/AIDS, cardiovascular diseases, cancers and tumors. Majority countries have legislation allowing for compulsory licensing and parallel importation of medicines, while the least legislated flexibilities were explicit exemption of pharmaceutical products from patentable subject matter, new or second use of patented pharmaceutical products, imposition of limits to patent term extension and test data protection. Thirty-nine countries have applied TRIPS flexibilities, with the most common being compulsory licensing and least developed country transition provisions. Conclusions Opportunities exist for WHO to work with ARIPO and OAPI to support countries in reviewing their legislation to be more responsive to public health needs.
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Affiliation(s)
- Marion Motari
- Adjunct Faculty, Daystar University School of Law, Nairobi, Kenya.
| | | | - Ossy M J Kasilo
- Adjunct Faculty, Daystar University School of Law, Nairobi, Kenya
| | | | - Andre Loua
- Adjunct Faculty, Daystar University School of Law, Nairobi, Kenya
| | - Aissatou Sougou
- Adjunct Faculty, Daystar University School of Law, Nairobi, Kenya
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Moeti M, Cabore J, Kasolo F, Yoti Z, Zawaira F, Chibi M, Rajatonirina S, Karamagi H, Rees H, Mihigo R, Yao M, Impouma B, Okeibunor JC, Talisuna AO. The COVID-19 pandemic: research and health development in the World Health Organisation Africa region. Pan Afr Med J 2021; 35:50. [PMID: 33623575 PMCID: PMC7875729 DOI: 10.11604/pamj.supp.2020.35.2.23628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/25/2020] [Indexed: 12/04/2022] Open
Abstract
Concerns have been expressed about the view point of WHO AFRO concerning research for health in the African Region. WHO AFRO considers research a critical component in the improvement of health in the Africa region. Ensuring the effectiveness of our strategies, policies and programmes requires evidence. In the context of the ongoing COVID-19 outbreak, WHO research interests cover key areas of the response. The WHO AFRO consider research as critical in our efforts at protecting people against health emergencies and pandemics like the COVID-19 and ensuring universal access to proven interventions. In view of this, the WHO has taken steps to strengthen capacity for research in the region. The results of these efforts may take time to manifest but will surely do as we persist in our drive, with support from our partners.
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Affiliation(s)
| | | | | | - Zabulon Yoti
- WHO Regional Office for Africa, Brazzaville, Congo
| | | | | | | | | | - Helen Rees
- Witwatersrand Reproductive Health and HIV Institute, South Africa
| | | | - Michel Yao
- WHO Regional Office for Africa, Brazzaville, Congo
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Ouedraogo L, Habonimana D, Nkurunziza T, Chilanga A, Hayfa E, Fatim T, Kidula N, Conombo G, Muriithi A, Onyiah P. Towards achieving the family planning targets in the African region: a rapid review of task sharing policies. Reprod Health 2021; 18:22. [PMID: 33485339 PMCID: PMC7825212 DOI: 10.1186/s12978-020-01038-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/05/2020] [Indexed: 02/02/2023] Open
Abstract
Background Expanding access and use of effective contraception is important in achieving universal access to reproductive healthcare services, especially in low- and middle-income countries (LMICs), such as those in sub-Saharan Africa (SSA). Shortage of trained healthcare providers is an important contributor to increased unmet need for contraception in SSA. The World Health Organization (WHO) recommends task sharing as an important strategy to improve access to sexual and reproductive healthcare services by addressing shortage of healthcare providers. This study explores the status, successes, challenges and impacts of the implementation of task sharing for family planning in five SSA countries. This evidence is aimed at promoting the implementation and scale-up of task sharing programmes in SSA countries by WHO. Methodology and findings We employed a rapid programme review (RPR) methodology to generate evidence on task sharing for family planning programmes from five SSA countries namely, Burkina Faso, Cote d’Ivoire, Ethiopia, Ghana, and Nigeria. This involved a desk review of country task sharing policy documents, implementation plans and guidelines, annual sexual and reproductive health programme reports, WHO regional meeting reports on task sharing for family planning; and information from key informants on country background, intervention packages, impact, enablers, challenges and ways forward on task sharing for family planning. The findings indicate mainly the involvement of community health workers, midwives and nurses in the task sharing programmes with training in provision of contraceptive pills and long-acting reversible contraceptives (LARC). Results indicate an increase in family planning indicators during the task shifting implementation period. For instance, injectable contraceptive use increased more than threefold within six months in Burkina Faso; contraceptive prevalence rate doubled with declines in total fertility and unmet need for contraception in Ethiopia; and uptake of LARC increased in Ghana and Nigeria. Some barriers to successful implementation include poor retention of lower cadre providers, inadequate documentation, and poor data systems. Conclusions Task sharing plays a role in increasing contraceptive uptake and holds promise in promoting universal access to family planning in the SSA region. Evidence from this RPR is helpful in elaborating country policies and scale-up of task sharing for family planning programmes.
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Affiliation(s)
- Leopold Ouedraogo
- Reproductive, Maternal Health and Ageing Team, World Health Organization, Regional Office for Africa, Brazzaville, Republic of the Congo.
| | - Desire Habonimana
- Department of Community Medicine, Research and Innovation Unit, Faculty of Medicine, University of Burundi, Bujumbura, Burundi
| | - Triphonie Nkurunziza
- Reproductive, Maternal Health and Ageing Team, World Health Organization, Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Asmani Chilanga
- Reproductive, Maternal Health and Ageing Team, Intercountry Support Team for West Africa, World Health Organization, Ouagadougou, Burkina Faso
| | - Elamin Hayfa
- Reproductive, Maternal Health and Ageing Team, Intercountry Support Team for East and Southern Africa, World Health Organization, Harare, Zimbabwe
| | - Tall Fatim
- Reproductive, Maternal Health and Ageing Team, Intercountry Support Team for West Africa, World Health Organization, Ouagadougou, Burkina Faso
| | - Nancy Kidula
- Reproductive, Maternal Health and Ageing Team, Intercountry Support Team for East and Southern Africa, World Health Organization, Harare, Zimbabwe
| | - Ghislaine Conombo
- Reproductive, Maternal Health and Ageing Team, Intercountry Support Team for Central Africa, World Health Organization, Libreville, Gabon
| | - Assumpta Muriithi
- Reproductive, Maternal Health and Ageing Team, World Health Organization, Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Pamela Onyiah
- Reproductive, Maternal Health and Ageing Team, World Health Organization, Regional Office for Africa, Brazzaville, Republic of the Congo
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Abstract
This paper addresses national responses to suicide prevention in the African region. Eighteen countries responded, of which none had a national suicide prevention strategy in place and only three countries, namely Algeria, Congo, and Madagascar, were in the process of developing any kind of strategy, at the time of this survey. Official national statistics on suicide were available in four of the 18 AFRO countries, with two countries publishing figures on suicide attempts nationally. Training programs on suicide assessment and interventions for general practitioners or mental health professionals were very limited, available in just four countries. One country had a national center specifically dedicated to suicide research or prevention and four countries have at least one NGO dedicated to suicide prevention. Postvention bereavement support for families affected by suicide was available in three AFRO countries. In more than half of the countries, suicide is not an option to certify cause of death. Statistics on suicide and suicide prevention are poorly monitored in all the 18 AFRO countries. The present state of suicide prevention in the region will require cross-country efforts that will generate a critical mass to move suicide advocacy in establishing national prevention strategies in the region.
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Affiliation(s)
- Joseph Osafo
- Department of Psychology, University of Ghana, Accra, Ghana.,Centre for Suicide and Violence Research (CSVR), Accra, Ghana
| | - Kwaku Oppong Asante
- Department of Psychology, University of Ghana, Accra, Ghana.,Centre for Suicide and Violence Research (CSVR), Accra, Ghana
| | - Charity Sylvia Akotia
- Department of Psychology, University of Ghana, Accra, Ghana.,Centre for Suicide and Violence Research (CSVR), Accra, Ghana
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Talisuna AO, Okiro EA, Yahaya AA, Stephen M, Bonkoungou B, Musa EO, Minkoulou EM, Okeibunor J, Impouma B, Djingarey HM, Yao NKM, Oka S, Yoti Z, Fall IS. Spatial and temporal distribution of infectious disease epidemics, disasters and other potential public health emergencies in the World Health Organisation Africa region, 2016-2018. Global Health 2020; 16:9. [PMID: 31941554 DOI: 10.1186/s12992-019-050-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/30/2019] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Emerging and re-emerging diseases with pandemic potential continue to challenge fragile health systems in Africa, creating enormous human and economic toll. To provide evidence for the investment case for public health emergency preparedness, we analysed the spatial and temporal distribution of epidemics, disasters and other potential public health emergencies in the WHO African region between 2016 and 2018. METHODS We abstracted data from several sources, including: the WHO African Region's weekly bulletins on epidemics and emergencies, the WHO-Disease Outbreak News (DON) and the Emergency Events Database (EM-DAT) of the Centre for Research on the Epidemiology of Disasters (CRED). Other sources were: the Program for Monitoring Emerging Diseases (ProMED) and the Global Infectious Disease and Epidemiology Network (GIDEON). We included information on the time and location of the event, the number of cases and deaths and counter-checked the different data sources. DATA ANALYSIS We used bubble plots for temporal analysis and generated graphs and maps showing the frequency and distribution of each event. Based on the frequency of events, we categorised countries into three: Tier 1, 10 or more events, Tier 2, 5-9 events, and Tier 3, less than 5 or no event. Finally, we compared the event frequencies to a summary International Health Regulations (IHR) index generated from the IHR technical area scores of the 2018 annual reports. RESULTS Over 260 events were identified between 2016 and 2018. Forty-one countries (87%) had at least one epidemic between 2016 and 2018, and 21 of them (45%) had at least one epidemic annually. Twenty-two countries (47%) had disasters/humanitarian crises. Seven countries (the epicentres) experienced over 10 events and all of them had limited or developing IHR capacities. The top five causes of epidemics were: Cholera, Measles, Viral Haemorrhagic Diseases, Malaria and Meningitis. CONCLUSIONS The frequent and widespread occurrence of epidemics and disasters in Africa is a clarion call for investing in preparedness. While strengthening preparedness should be guided by global frameworks, it is the responsibility of each government to finance country specific needs. We call upon all African countries to establish governance and predictable financing mechanisms for IHR implementation and to build resilient health systems everywhere.
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Affiliation(s)
- Ambrose Otau Talisuna
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo.
| | - Emelda Aluoch Okiro
- Population Health Unit, Kenya Medical Research Institute - Wellcome Trust Research Programme, P.O. Box 43640-00100, Nairobi, Kenya
| | - Ali Ahmed Yahaya
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Mary Stephen
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Boukare Bonkoungou
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Emmanuel Onuche Musa
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | | | - Joseph Okeibunor
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Benido Impouma
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Haruna Mamoudou Djingarey
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - N'da Konan Michel Yao
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Sakuya Oka
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Zabulon Yoti
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Ibrahima Socé Fall
- World Health Organization, Emergency Response Department, Health Emergencies programme, Geneva, Switzerland
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Talisuna AO, Okiro EA, Yahaya AA, Stephen M, Bonkoungou B, Musa EO, Minkoulou EM, Okeibunor J, Impouma B, Djingarey HM, Yao NKM, Oka S, Yoti Z, Fall IS. Spatial and temporal distribution of infectious disease epidemics, disasters and other potential public health emergencies in the World Health Organisation Africa region, 2016-2018. Global Health 2020; 16:9. [PMID: 31941554 DOI: 10.1186/s12992-019-0540-4] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/30/2019] [Indexed: 11/17/2022] Open
Abstract
Background Emerging and re-emerging diseases with pandemic potential continue to challenge fragile health systems in Africa, creating enormous human and economic toll. To provide evidence for the investment case for public health emergency preparedness, we analysed the spatial and temporal distribution of epidemics, disasters and other potential public health emergencies in the WHO African region between 2016 and 2018. Methods We abstracted data from several sources, including: the WHO African Region’s weekly bulletins on epidemics and emergencies, the WHO-Disease Outbreak News (DON) and the Emergency Events Database (EM-DAT) of the Centre for Research on the Epidemiology of Disasters (CRED). Other sources were: the Program for Monitoring Emerging Diseases (ProMED) and the Global Infectious Disease and Epidemiology Network (GIDEON). We included information on the time and location of the event, the number of cases and deaths and counter-checked the different data sources. Data analysis We used bubble plots for temporal analysis and generated graphs and maps showing the frequency and distribution of each event. Based on the frequency of events, we categorised countries into three: Tier 1, 10 or more events, Tier 2, 5–9 events, and Tier 3, less than 5 or no event. Finally, we compared the event frequencies to a summary International Health Regulations (IHR) index generated from the IHR technical area scores of the 2018 annual reports. Results Over 260 events were identified between 2016 and 2018. Forty-one countries (87%) had at least one epidemic between 2016 and 2018, and 21 of them (45%) had at least one epidemic annually. Twenty-two countries (47%) had disasters/humanitarian crises. Seven countries (the epicentres) experienced over 10 events and all of them had limited or developing IHR capacities. The top five causes of epidemics were: Cholera, Measles, Viral Haemorrhagic Diseases, Malaria and Meningitis. Conclusions The frequent and widespread occurrence of epidemics and disasters in Africa is a clarion call for investing in preparedness. While strengthening preparedness should be guided by global frameworks, it is the responsibility of each government to finance country specific needs. We call upon all African countries to establish governance and predictable financing mechanisms for IHR implementation and to build resilient health systems everywhere.
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Perovic O, Yahaya AA, Viljoen C, Ndihokubwayo JB, Smith M, Coulibaly SO, De Gouveia L, Oxenford CJ, Cognat S, Ismail H, Frean J. External Quality Assessment of Bacterial Identification and Antimicrobial Susceptibility Testing in African National Public Health Laboratories, 2011-2016. Trop Med Infect Dis 2019; 4:tropicalmed4040144. [PMID: 31847247 PMCID: PMC6958417 DOI: 10.3390/tropicalmed4040144] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/05/2019] [Accepted: 12/09/2019] [Indexed: 12/22/2022] Open
Abstract
Background: In 2002, the World Health Organization (WHO) launched a regional microbiology external quality assessment (EQA) programme for national public health laboratories in the African region, initially targeting priority epidemic-prone bacterial diseases, and later including other common bacterial pathogens. Objectives: The aim of this study was to analyse the efficacy of an EQA programme as a laboratory quality system evaluation tool. Methods: We analysed the proficiency of laboratories’ performance of bacterial identification and antimicrobial susceptibility testing (AST) for the period 2011–2016. The National Institute for Communicable Diseases of South Africa provided technical coordination following an agreement with WHO, and supplied EQA samples of selected bacterial organisms for microscopy (Gram stain), identification, and antimicrobial susceptibility testing (AST). National public health laboratories, as well as laboratories involved in the Invasive Bacterial Diseases Surveillance Network, were enrolled by the WHO Regional Office for Africa to participate in the EQA programme. We analysed participants’ results of 41 surveys, which included the following organisms sent as challenges: Streptococcus pneumonia, Haemophilus influenzae, Neisseria meningitidis, Salmonella Typhi, Salmonella Enteritidis, Shigella flexneri, Staphylococcus aureus, Streptococcus agalactiae, Streptococcus anginosus, Enterococcus faecium, Serratia marcescens, Acinetobacter baumannii, and Enterobacter cloacae. Results: Eighty-one laboratories from 45 countries participated. Overall, 76% of participants obtained acceptable scores for identification, but a substantial proportion of AST scores were not in the acceptable range. Of 663 assessed AST responses, only 42% had acceptable scores. Conclusion: In the African Region, implementation of diagnostic stewardship in clinical bacteriology is generally suboptimal. This report illustrates that AST is poorly done compared to microscopy and identification. It is critically important to make the case for implementation of quality assurance in AST, as it is the cornerstone of antimicrobial resistance surveillance reporting and implementation of the Global Antimicrobial Resistance Surveillance System.
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Affiliation(s)
- Olga Perovic
- National Institute for Communicable Diseases, Division of National Health Laboratory Service, Johannesburg 2131, South Africa
- Department of Clinical Microbiology, University of Witwatersrand, Johannesburg 2193, South Africa
- Correspondence:
| | - Ali A. Yahaya
- World Health Organization, Regional Office for Africa, Brazzaville 06, Congo; (A.A.Y.); (J.-B.N.); (S.O.C.)
| | - Crystal Viljoen
- Department of Clinical Microbiology, University of Witwatersrand, Johannesburg 2193, South Africa
| | - Jean-Bosco Ndihokubwayo
- World Health Organization, Regional Office for Africa, Brazzaville 06, Congo; (A.A.Y.); (J.-B.N.); (S.O.C.)
| | - Marshagne Smith
- National Institute for Communicable Diseases, Division of National Health Laboratory Service, Johannesburg 2131, South Africa
| | - Sheick O. Coulibaly
- World Health Organization, Regional Office for Africa, Brazzaville 06, Congo; (A.A.Y.); (J.-B.N.); (S.O.C.)
| | - Linda De Gouveia
- National Institute for Communicable Diseases, Division of National Health Laboratory Service, Johannesburg 2131, South Africa
| | | | | | - Husna Ismail
- National Institute for Communicable Diseases, Division of National Health Laboratory Service, Johannesburg 2131, South Africa
| | - John Frean
- National Institute for Communicable Diseases, Division of National Health Laboratory Service, Johannesburg 2131, South Africa
- WITS Research Institute for Malaria, University of Witwatersrand, Johannesburg 2193, South Africa
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Nsubuga P, Masiira B, Ibrahim L, Ndakala N, Dongmo N. The contribution of the polio eradication initiative on the operations and outcomes of non-polio public health programs: a survey of programs in the African region. Pan Afr Med J 2019; 31:207. [PMID: 31447967 PMCID: PMC6691281 DOI: 10.11604/pamj.2018.31.207.17666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 11/20/2018] [Indexed: 11/11/2022] Open
Abstract
Introduction The effect of the Global polio eradication initiative (PEI) on public health programs beyond polio is widely debated. PEI contribution to other health programs has been assessed from the perspective of polio-funded personnel, which may introduce bias as PEI staff are probably more likely to show that they have benefited of other programs. We set out to identify and document how public health programs have benefited from the public health capacity that was provided at the country level as part of the PEI program in a systematic and standardized manner. Methods Between July and November 2017, we conducted a mixed-methods cross-sectional study, which combined two methods: a multi-country quantitative survey and a qualitative study. We created a self-administered electronic multi-lingual questionnaire in English, French and Portuguese. The qualitative study, which followed an interim analysis of the quantitative survey, comprised interviews with national and subnational level staff in a few countries. Results A total of 127 public health workers from 43 of the 47 countries in the African WHO Region responded online. Most of the respondents 56/127 (42.7%) belonged to the immunization sector and 51/127 (38.9%) belonged to the emergencies and outbreaks sector. Respondents who identified themselves with the immunization (50/64 (78%)) and maternal health program (64/82 (78%)) reported the highest level of greatly benefiting from PEI resources. A total of 78/103 (76%) respondents rated PEI's contribution data management system to their program very high and high. Of the 127 respondents, the majority 91 (71.6%) reported that the withdrawal of PEI resources would result in a weakening of surveillance for other diseases; 88 (62.9%) reported that there would be inadequate resources to carry out planned activities and 80 (62.9%) reported that there would be poor logistics and transport for implementation of activities. Cameroon, DRC, Nigeria and Uganda participated in the qualitative study. Each country had between 7-8 key informants from the national and sub-national level for a total of 31 key informants. Polio funds and other PEI resources have supported various activities in the ministries of health of the four countries especially IDSR, data management, laboratories and development of the public health workforce. Respondents believed that the infrastructure and processes that PEI has created need to be maintained, along with the workforce and they believed that this was an essential role of their governments with support from the partners. Conclusion There is a high awareness of the PEI program in all the countries and at all levels which should be leveraged into improving other child survival activities for example routine immunizations. Future large-scale programs of this nature should be designed to benefit other public health programs beyond the specific program. The public health workforce, surveillance development, data management and laboratory strengthening that have been developed by PEI need to be maintained.
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Affiliation(s)
- Peter Nsubuga
- Global Public Health Solutions, Atlanta, Georgia, USA
| | - Ben Masiira
- Global Public Health Solutions, Atlanta, Georgia, USA
| | - Luka Ibrahim
- Global Public Health Solutions, Atlanta, Georgia, USA
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14
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Fall IS, Rajatonirina S, Yahaya AA, Zabulon Y, Nsubuga P, Nanyunja M, Wamala J, Njuguna C, Lukoya CO, Alemu W, Kasolo FC, Talisuna AO. Integrated Disease Surveillance and Response (IDSR) strategy: current status, challenges and perspectives for the future in Africa. BMJ Glob Health 2019; 4:e001427. [PMID: 31354972 PMCID: PMC6615866 DOI: 10.1136/bmjgh-2019-001427] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 05/13/2019] [Accepted: 05/18/2019] [Indexed: 11/04/2022] Open
Abstract
In 1998, the WHO African region adopted a strategy called Integrated Disease Surveillance and Response (IDSR). Here, we present the current status of IDSR implementation; and provide some future perspectives for enhancing the IDSR strategy in Africa. In 2017, we used two data sources to compile information on the status of IDSR implementation: a pretested rapid assessment questionnaire sent out biannually to all countries and quarterly compilation of data for two IDSR key performance indicators (KPI). The first KPI measures country IDSR performance and the second KPI tracks the number of countries that the WHO secretariat supports to scale up IDSR. The KPI data for 2017 were compared with a retrospective baseline for 2014. By December 2017, 44 of 47 African countries (94%) were implementing IDSR. Of the 44 countries implementing IDSR, 40 (85%) had initiated IDSR training at subnational level; 32 (68%) had commenced community-based surveillance; 35 (74%) had event-based surveillance; 33 (70%) had electronic IDSR; and 32 (68%) had a weekly/monthly bulletin for sharing IDSR data. Thirty-two countries (68%) had achieved the timeliness and completeness threshold of at least 80% of the reporting units. However, only 12 countries (26%) had the desired target of at least 90% IDSR implementation coverage at the peripheral level. After 20 years of implementing IDSR, there are major achievements in the indicator-based surveillance systems. However, major gaps were identified in event-based surveillance. All African countries should enhance IDSR everywhere.
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Affiliation(s)
- Ibrahima Socé Fall
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Soatiana Rajatonirina
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Ali Ahmed Yahaya
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Yoti Zabulon
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | - Peter Nsubuga
- Global Public Health Solutions, Atlanta, Georgia, USA
| | | | - Joseph Wamala
- World Health Organization, Country Office, Juba, South Sudan
| | - Charles Njuguna
- World Health Organization, Country Office, Free Town, Sierra Leone
| | - Charles Okot Lukoya
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
| | | | - Francis Chisaka Kasolo
- World Health Organization, Regional Office for Africa, Country Support, Brazzaville, Congo
| | - Ambrose Otau Talisuna
- World Health Organization, Regional Office for Africa, Health Emergencies programme, Brazzaville, Congo
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Lin Y, Koh JKH, Shao L, Li S. Description on two species of genus Platythomisus (Araneae, Thomisidae) from China and Singapore. Zookeys 2019; 852:73-84. [PMID: 31210743 PMCID: PMC6562001 DOI: 10.3897/zookeys.852.34436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 04/25/2019] [Indexed: 11/29/2022] Open
Abstract
Two species of the genus Platythomisus Doleschall, 1859 are studied: P.xiandao Lin & Li, sp. nov. is described based on male and female specimens from Yunnan, China, and P.octomaculatus (C. L. Koch, 1845), the type species of the genus, is redescribed based on female specimens from Singapore. Its male, also from Singapore, is described for the first time.
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Affiliation(s)
- Yejie Lin
- College of Life Science, Langfang Normal University, Langfang 065000, Hebei Province, China Langfang Normal University Langfang China
| | - Joseph K H Koh
- National Biodiversity Centre, National Parks Board, 259598, Singapore National Biodiversity Centre Singapore Singapore
| | - Lili Shao
- Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China Institute of Zoology, Chinese Academy of Sciences Beijing China
| | - Shuqiang Li
- Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China Institute of Zoology, Chinese Academy of Sciences Beijing China
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Tevi-Benissan C, Okeibunor J, du Châtellier GM, Assefa A, Biey JNM, Cheikh D, Eshetu M, Anya BP, Dao H, Nasir Y, Akanmori BD, Mihigo R. Introduction of Inactivated Poliovirus Vaccine and Trivalent Oral Polio Vaccine/Bivalent Oral Polio Vaccine Switch in the African Region. J Infect Dis 2017; 216:S66-S75. [PMID: 28838178 PMCID: PMC5853502 DOI: 10.1093/infdis/jiw616] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The Polio Eradication and Endgame Strategic plan outlines the phased removal of oral polio vaccines (OPVs), starting with type 2 poliovirus–containing vaccine and introduction of inactivated polio vaccine in routine immunization to mitigate against risk of vaccine-associated paralytic polio and circulating vaccine-derived poliovirus. The objective includes strengthening routine immunization as the primary pillar to sustaining high population immunity. After 2 years without reporting any wild poliovirus (July 2014–2016), the region undertook the synchronized switch from trivalent OPV (tOPV) to bivalent OPV (bOPV) as recommended by the Strategic Advisory Group of Experts on Immunization. Consequently the 47 countries of the World Health Organization (WHO) African Region switched from the use of tOPV to bOPV within the stipulated period of April 2016. Planning started early, routine immunization was strengthened, and technical and financial support was provided for vaccine registration, procurement, destruction, logistics, and management across countries by WHO in collaboration with the United Nations Children’s Fund (UNICEF) and partners. National commitment and ownership, as well as strong coordination and collaboration between UNICEF and WHO and with partners, ensured success of this major, historic public health undertaking.
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Affiliation(s)
- Carol Tevi-Benissan
- Immunization and Vaccines Development Programme, Family and Reproductive Health Cluster
| | - Joseph Okeibunor
- Polio Eradication Programme, Office of the Regional Director, World Health Organization (WHO) Regional Office for Africa, Brazzaville, Congo
| | | | - Afework Assefa
- UNICEF Regional Office for East and Southern Africa, Nairobi, Kenya
| | - Joseph Nsiari-Muzenyi Biey
- Immunization and Vaccines Development Programme, WHO Intercountry Support Team for West Africa, Ouagadougou, Burkina Faso
| | - Dah Cheikh
- Immunization and Vaccines Development Programme, WHO Intercountry Support Team for Central Africa, Libreville, Gabon
| | - Messeret Eshetu
- Immunization and Vaccines Development Programme, WHO Intercountry Support Team for East and Southern Africa, Harare, Zimbabwe
| | | | - Halima Dao
- United Nations Children's Fund (UNICEF) Regional Office for West and Central Africa, Dakar, Senegal
| | - Yusuf Nasir
- UNICEF Regional Office for East and Southern Africa, Nairobi, Kenya
| | | | - Richard Mihigo
- Immunization and Vaccines Development Programme, Family and Reproductive Health Cluster
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Abstract
Immunization has made significant contribution to public health in the African Region, including elimination, eradication and control of life threatening diseases. Hospitalization due to vaccine preventable diseases has been drastically reduced due to introduction of new effective vaccines. However, optimizing the benefits of immunization by achieving high universal coverage has met with many challenges. The Regional immunization coverage, though raised from its low 57% in 2000 to 76% in 2015 has remained below expected target. Worse still, it has stagnated around 70% for a prolonged period. Cases of inequity in access to immunization service continue to exist in the region. This paper therefore explored the different challenges to immunization in the African Region. Some of the challenges it identifies and discusses include issues of sustainable funding and resources for immunization, vaccine stock-outs, and logistics. Others include data issues and laboratory infrastructure. The paper also attempted some possible solutions.
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Affiliation(s)
| | | | - Blanche Anya
- WHO Regional Office for Africa, Brazzaville, Congo
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